There is no universally-accepted definition of elder abuse. A commonly cited definition of elder abuse is that developed by World Health Organization (WHO) (2002): 'a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person'. [1-6] The phenomenon is often categorised as physical, sexual, psychological and emotional, financial and material abuse, abandonment and neglect. [1-6] The Australian Law Reform Commission also includes chemical abuse which describes unnecessary sedation of older people.  Resident-to-resident abuse is an emerging type of elder abuse.  Self-neglect is a well-known geriatric syndrome and is not always regarded as elder abuse. 
While a detailed picture of elder abuse in Australia based on solid evidence does not exist. [1,2] There is even less information of elder abuse in a palliative care context.
Abuse or neglect may occur within families, between residents or be perpetrated by staff. Risk factors for older people are cognitive impairment or disability, isolation from a social network and community support, and intensive or exclusive interaction with a primary carer. [4,6,9] Lack of resources and training, burnout and stress in the work environment may also contribute to elder abuse by members of the aged care workforce.  Important cultural factors relating to abuse and neglect of older people are emerging [2,5,9,11] and are important in the context of aged care in Australia. Only one study focussed on the older people’s understanding of elder abuse.
Service providers – individuals and organisations – have a moral, ethical and regulatory responsibility to recognise, prevent and redress neglect and harm of older people. The requirements for reporting are evolving and people need to be aware of the legislative requirements for action and the protective and supportive resources which are available. [1-3] However, service providers may need to distinguish between situations of family stress rather than abuse in deciding what action to take. 
Different interventions have been studied  but their effect is unclear and recommendations are difficult to make as the studies are generally scarce, of low quality, diverse in their intent and design, and on a small scale.
The included systematic reviews are of variable quality and include research of variable methodological design and rigour. Research into elder abuse is growing but is hampered by a lack of agreement on definitions and measurement.
Page updated 24 May 2017